Advances in Tissue Banking

The following sections are included:

• ADVANCES IN TISSUE BANKING

• PREFACE

• CONTENTS

Safe donor selection is the goal of every tissue banker. This chapter deals with risk factors associated with primary tumours and contamination in corneal transplantation and during post mortem procurement of allograft bone.

The following sections are included:

• Introduction

• Donors with Primary Brain Tumours

• Consent Document

• Procedures to Prevent Tumour Transmission from Donors with PBTs

• Conclusions

• References

The following sections are included:

• Introduction

• Endophthalmitis After Corneal Transplantation

• Positive Donor Corneal Rim Cultures

• Positive Donor Corneal Rim Cultures and Patients with Endophthalmitis

• A Positive Rim Culture: Is It a Risk Factor for Endophthalmitis?

• Risk Factors for Positive Corneal Rim Cultures
  • Donor sepsis
  • Respirator use
  • Storage time interval
  • Harvesting technique and decontamination procedure
  • Storage medium
  • Other risk factors

• Summary

• References

The following sections are included:

• Introduction

• Infection of Bone Allografts

• Microbiological Screening

• Studies on Contamination Rates

• Recommendations

• References

The following sections are included:

• Introduction

• Aims and Equipment for Freeze Drying

• Properties of Freeze Dried Bone
  • Mechanical properties
  • Biological properties

• Preparation of Bone to be Freeze Dried

• Clinical Indications of Freeze Dried Bones
  • Non-demineralised bone
    • Locations
    • Reliability of freeze dried bone in a clinical setting
    • Freeze dried bone allograft as an antibiotic carrier, or can a bone allograft be used in a septic environment?
  • Demineralised bone

• Conclusions

• References

The following sections are included:

• Introduction

• Results
  • Osteoarticular allografts
  • Megaprostheses
    • Shoulder
    • Hip
    • Knee

• Discussion
  • Proximal humerus
  • Proximal femur
  • Distal femur
  • Proximal tibia

• Conclusions

• References

The following sections are included:

• Introduction

• Previous Research on Bone Formation Using DFDB

• Osteoinduction Capacity

• Modifications

• Biological Healing Capacity of DFDB Powders and Their Response to the Titanium Screw

• Safety and Clinical Application of DFDB in Human

• Conclusion

• Acknowledgement

• References

The following sections are included:

• Introduction

• Material and Methods
  • Preparation of DBM
  • Demographics

• Results

• Discussion

• Acknowledgement

• References

The following sections are included:

• Introduction

• Cleaning of Bone

• Demineralization of Bone

• Determination of Osteoinductive Potential of Bone

• Summary and Conclusions

• References

The following sections are included:

• Introduction

• Allograft Take

• Clinical Features of Allografts
  • Restoration of the physical barrier
  • Reduction of infection
  • Reduction in pain
  • Promotion of wound healing
  • Revascularisation of the wound bed
  • Ease of application
  • Allograft rejection
  • Disease transmission

• Clinical Indications
  • Partial-thickness burns
  • Temporary coverage for excised full-thickness burns
  • Allograft overlay for widely expanded autografts
  • Preparation of wounds for grafting

• Types of Allograft
  • Fresh allografts
  • Cryopreserved skin
  • Glycerol-preserved allografts
  • Freeze dried allografts

• Future Considerations

• Conclusion

• References

The following sections are included:

• Introduction

• The Skin and Wound Healing

• Burn Injury

• Allograft Skin As a Biological Dressing

• Preservation of Allograft Skin

• Limitation of Allograft Skin

• Dermal Transplants

• The AlloDerm® Process

• Properties of the Acellular Dermal Matrix

• Applications of an Acellular Dermal Matrix

• Summary

• References

The following sections are included:

• Introduction

• Immune Responses to Viable Tissue Grafts
  • Normal afferent inductive response to foreign antigen
  • Afferent inductive response to allogeneic tissue
  • Normal Tc-effector response to e.g. virus infected cells
  • Tc-effector response to allogeneic tissue
  • Abrogating the acute allograft rejection response
  • The role of Th1- and Th2-cells
  • Chemokines
  • Conclusions — viable tissue grafts

• Immune Responses to Non-Viable Tissue Grafts

• Conclusion

• References

The following sections are included:

• Introduction

• Establishment of Tissue Bank

• Bacteriological Testing of Heart Valves

• Viability Testing of Heart Valves

• Cryopreservation

• Immunology

• Homograft Implantation in Patients Suffering from Endocarditis

• Acknowledgements

• References

The following sections are included:

• Introduction

• Material and Methods

• Results
  • Cryopreserved allografts in aortic position at ten years
  • Cryopreserved allografts in RVOT at eight years

• Comments

• Conclusion

• References

Continually, there is a search for more effective processing and sterilisation procedures. Here two systems are reviewed, both in their own way controversial. Regularly for tissue sterilisation 25 kGy is routinely applied. Dr Yusof identifies the basis for dose selection, and demonstrates its relationship to initial bioburden. Sufficient inactivation is necessary to achieve a Sterility Assurance Level of 10⁻⁶ for implanted tissue and 10⁻³ for topical application. Tissue bankers need to take account of the principles of radiation sciences when using this technology, as illustrated in this chapter…

The following sections are included:

• Introduction

• Irradiation of Tissues

• Selection and Validation of Sterlisation Dose
  • Inactivation of micro-organisms
  • Dose setting

• Product Integrity

• Dosimetry
  • Dose validation
  • Certification

• Conclusion

• References

The following sections are included:

• Introduction

• Aim of Studies

• Mechanical Properties of Heat-treated Bone
  • Material and methods
    • Compression test on porcine femoral head cancellous bone cylinders
    • Tension screw pullout test with human and porcine femoral head cancellous bone cylinders
  • Results
    • Compression test on porcine femoral head cancellous bone cylinders
    • Tension screw pullout test with human and porcine femoral head cancellous bone cylinders

• Biological Response
  • Material and methods
  • Results

• Thermophysical Findings
  • Material and methods
  • Results

• Development of Marburg Bone Bank System (Lobator SD-1 and SD-2)

• Red Blood Cell (RBC) Antigenicity
  • Material and methods
  • Results

• Bacteriological Testing
  • Material and methods
  • Results

• Virological Safety
  • Herpes-, entero- and arboviruses
    • Material and methods
    • Results
  • HIV
    • Material and methods
    • Results
  • BVDV (model virus for hepatitis C)
    • Material and methods
    • Results
  • CPV (model virus for human parvovirus B19)
    • Material and methods
    • Results

• Clinical Findings
  • Prospective clinical study
  • Results

• Discussion
  • Heat treatment of bone allografts
  • Mechanical properties of heat-treated bone
  • 80°C effect on osteointegration properties of cancellous bone
  • Operation of Marburg Bone Bank System
  • 80°C effect on red blood cell antigenicity
  • 80°C effect on human pathogenic vegetative bacteria
  • 80°C effect on human pathogenic viruses
  • Virus inactivation validation studies using the Lobator Bone Bank System
  • Prospective clinical trial

• Conclusion

• References

Biomaterials hold the promise to become partners of the tissue banker. The limitations of human tissue alone can sometimes be overcome by the use in composite form in association with tissue. Hyaluronan is presently such an emerging material, which holds promise in a number of fields, particular to promote wound healing. It is valuable because it itself is found in all connective tissue, and can be produced in a biocompatible form. This chapter illustrates certain proven benefits derived from this ubiquitous starting material…

The following sections are included:

• Introduction

• Molecular Weight and Morphological Structure
  • Main chain
  • Average molecular weight (M_r)
  • Aggregation and network formations: Study using atomic force microscopy

• The Influence of Structure on the Functionality of Hylans
  • Water binding
  • Structural elasticity
  • Stability to free radical degradation

• Conclusion

• Acknowledgement

• References

The International Atomic Energy Agency (IAEA) gave an enormous impetus to the development of tissue banks in the Asia-Pacific Region. The work developed gradually first from the early 1970s, but has gained momentum in recent years, mainly due to the need in the region for allografts and the development of medical expertise in their use. This development is described and some of the tissue banks which have resulted are profiled. As the activity grew, so did the Asia-Pacific Association for Surgical Tissue Banking, due mainly to the initiative of Dr. Y. Vajaradul of the Bangkok Biomedical Center. Dr. Aziz Nather outlines both the existing structure and offshoot developments…

The following sections are included:

• Historical Development

• Contribution of IAEA Technical Officers

• Some of the IAEA-supported Tissue Banks
  • Bangladesh
  • China
  • India
  • Indonesia
  • Republic of Korea
  • Malaysia
  • Pakistan
  • The Philippines
  • Singapore
  • Sri Lanka
  • Vietnam
  • Thailand
  • Latin America

• IAEA Thematic Approach to Radiation and Tissue Banking

• Reference

The following sections are included:

• Introduction

• Japan

• Australia

• Pan-Asiatic Tissue Banking Association

• Asia-Pacific Association of Surgical Tissue Banking

• Presidents of APASTB

• Scientific Meetings of APASTB

• Current Office Holders of APASTB

• Regional Training Centre for IAEA Regional Cooperative Agreement (RCA) Programme

• Current Status of APASTB

• Future Role of APASTB

• References

The following sections are included:

• Introduction

• The Musculoskeletal Tissue Bank
  • Infrastructure and personnel
  • Procurement storage and processing of tissues
  • Documentation and screening tests
  • Quality control procedures

• Clinical Use of Tissue Allografts

• Integrating Research with Service: A New Initiative By Our Tissue Bank

• Acknowledgment

• References

The following sections are included:

• Introduction

• The Current State of Tissue Banking in Japan

• Donation, Retrieval, Processing, and Storage at ABTRI

• Quality Control

• Results

• Discussion

• References

The following sections are included:

• Amnion Grafts

• Bone Grafts

• Summary

The following sections are included:

• Introduction

• Methods
  • Microbial load in amniotic membranes

• Characterisation of Bacteria Isolated from Amniotic Membranes

• Effect of Radiation on the Isolated Bacteria

• Results and Discussion

• Summary

• Acknowledgements

• References

The following sections are included:

• Introduction

• Materials and Methods

• Results and Discussion

• Summary

• Acknowledgements

• References

The following sections are included:

• Introduction

• Materials and Methods

• Results

• Discussion

• Summary

• References

The following sections are included:

• Introduction

• Materials and Methods

• Clinical Application

• Results

• Discussion
  • Advantages

• Conclusion

• Summary

• References

The following sections are included:

• Introduction

• Materials and Methods

• Results

• Discussion

• Conclusions

• Summary

• References

The following sections are included:

• Preparation of the Wound

• Results of the Study

• Conclusions

• Summary

• References